Diabetes, prediabetes may signal disability in middle-aged adults

The presence of diabetes or prediabetes appears to worsen the risk of disability and mortality, reports a recent Japan study.

Researchers conducted a follow-up analysis of the 1990 study National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged (NIPPON DATA90). The present analysis included 1,788 adults (aged 45–64 years at baseline) in whom disability was measured using the Katz questionnaire. Death without disability over the 22-year follow-up was also assessed.

At baseline, 31.6 percent (n=563) of participants had prediabetes, while 12.0 percent (n=215) were diagnosed with diabetes. Hypertension and dyslipidaemia were more common in diabetics and prediabetics than in those with normal glucose tolerance. Over the following 22 years, 334 participants (18.6 percent) developed disability, while 350 (19.5 percent) died without disability.

Disability occurred more frequently in those with prediabetes and diabetes than participants with normal glucose tolerance (21.9 percent and 23.9 percent vs 15.8 percent, respectively), as did death without disability (23.2 percent and 27.4 percent vs 15.9 percent, respectively).

Multinomial logistic regression, completely adjusted for confounders, confirmed that prediabetes was a significant correlate of disability (adjusted odds ratio [OR], 1.43, 95 percent confidence interval [CI], 1.07-1.91; p=0.014) and death without disability (adjusted OR, 1.56, 95 percent CI, 1.16–2.08; p=0.003).

Diabetes was likewise important, raising the likelihood of both outcomes by approximately 70 percent (disability: adjusted OR, 1.66, 95 percent CI, 1.10–2.50; p=0.014; death without disability: adjusted OR, 1.77, 95 percent CI, 1.18–2.65; p=0.006).